Nasal polyps and chronic rhinosinusitis

Abstract:

Current treatment paradigm for chronic rhinosinusitis with nasal polyps (CRSwNP) recommends nasal steroids and saline nasal lavage for milder cases, and oral corticosteroids and possible surgery for severe cases. The most common endotype of CRSwNP is type 2 inflammation. As a result of the common type 2 inflammatory pathway, CRSwNP is often associated with asthma and/or salicylate sensitivity. Classification of chronic rhinosinusitis into different endotypes leads to more precise treatment strategies. The classification of endotypes into type 2 or non-type 2 will probably be further developed for the treatment purposes in the future. Biologic therapy focused on the pathophysiology of the underlying inflammatory disease type 2 has led to a significant shift in the treatment options for CRSwNP, primarily for the most severe cases, refractory to standard treatment. Our experience proved biologics effective in patients with CRSwNP, to whom biologics were prescribed because of severe asthma.

Key words:
chronic rhinosinusitis with nasal polyps; management of nasal polyps; sinus diseases; type 2 inflammation